Risk factors for recurrence of ovarian endometriomas after surgical excision.
10.1007/s11596-014-1261-9
- Author:
Ming YUAN
1
;
Wen-wen WANG
;
Yan LI
;
Ling GAO
;
Tian WANG
;
Shi-xuan WANG
Author Information
1. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China, yuan_7566pig@163.com.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Age Factors;
Endometriosis;
pathology;
surgery;
Female;
Follow-Up Studies;
Humans;
Laparoscopy;
adverse effects;
methods;
Middle Aged;
Neoplasm Recurrence, Local;
pathology;
surgery;
Ovarian Neoplasms;
pathology;
surgery;
Postoperative Period;
Pregnancy;
Proportional Hazards Models;
Risk Factors
- From:
Journal of Huazhong University of Science and Technology (Medical Sciences)
2014;34(2):213-219
- CountryChina
- Language:English
-
Abstract:
Ovarian endometrioma is a common form of endometriosis, which may cause infertility, dysmenorrhea and pelvic pain in women of reproductive age. Although surgery is the treatment of choice for endometriomas, recurrence poses a formidable frustration. This study investigated potential risk factors of endometriomas recurrence, aiming to better understand its pathogenesis. A total of 307 patients with endometriomas were followed up for an average of 28.6 months and the 1-, 2- and 3-year cumulative recurrence rate was 9.5%, 21.9%, and 29.2%, respectively. Twenty-one potential risk factors for endometriomas recurrence were evaluated using Cox's proportional hazards models. Total revised American Fertility Society (rAFS) score was significantly associated with higher recurrence (OR=1.858, 95% CI=1.122-3.075, P=0.016), as well as younger age at surgery (OR=0.953, 95% CI=0.915-0.992, P=0.020). Semiradical surgical treatment was defined as surgical removal of cyst plus hysterectomy with preservation of bilateral or unilateral ovary, and was a significant factor that was associated with lower recurrence than the conservative surgery (OR=0.318, 95% CI=0.107-0.951, P=0.040). Postoperative pregnancy was favorable factors for disease recurrence (OR=0.217, 95% CI=0.102-0.460, P=0.000). The results suggest that endometrioma recurrence is inversely associated with age at surgery and postoperative pregnancy, and may correlate with total rAFS score and conservative surgery method.
